Military medicine
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Observational Study
Persistent MRI Findings Unique to Blast and Repetitive Mild TBI: Analysis of the CENC/LIMBIC Cohort Injury Characteristics.
MRI represents one of the clinical tools at the forefront of research efforts aimed at identifying diagnostic and prognostic biomarkers following traumatic brain injury (TBI). Both volumetric and diffusion MRI findings in mild TBI (mTBI) are mixed, making the findings difficult to interpret. As such, additional research is needed to continue to elucidate the relationship between the clinical features of mTBI and quantitative MRI measurements. ⋯ In deployment-related mTBI, significant findings in this cohort were only observed when considering mTBI sub-groups (blast mechanism and total number/dose). Simply comparing healthy controls and those with a positive mTBI history is likely an oversimplification that may lead to non-significant findings, even in consortium analyses.
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Intraosseous (IO) infusion, the pressurized injection of fluids into bone through a catheter, is a life-preserving resuscitative technique for treating trauma patients with severe hemorrhage. However, little is known regarding the application times, placement accuracy, and end-user ratings of battery-powered and manual IO access devices. This study was specifically designed to fill these knowledge gaps on six FDA-approved IO access devices. ⋯ The battery-powered EZ-IO performed best and remains the IO access device of choice. The present findings suggest that the TALON should be considered as a manual backup to the EZ-IO.
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Historical Article
Nord-Ost: Russia's Medical Failure in the 2002 Crisis.
The 2002 hostage crisis at a Moscow theater transfixed the attention of the world. While the initial assault, led by Spetsnaz commandos, successfully secured the building, the Russian security force's utter failure at coordinating with medical services led to the preventable deaths of over 100 hostages.
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Research finds that experiencing psychological stress can be associated with engaging in less physical activity, a critical contributor to operational readiness and overall health and well-being. As navy personnel tend to engage in lower levels of physical activity than other military personnel, the purpose of this study was to examine the relationship between stress and physical activity in the Royal Canadian Navy (RCN) and identify moderators of this relationship. ⋯ The findings of this study support a complex relationship between experiencing stress and engaging in physical activity, which showed varying patterns based on BMI classification. Although the cross-sectional nature of the data precludes any inferences about the direction of these effects, the results suggest that some members of the RCN are more at risk of experiencing decrements in physical activity. Future research should examine the types of physical activity supports and incentives that are needed to ensure that navy personnel derive the benefits of an active lifestyle, especially in times of stress.
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Case Reports
Suspected Mal de Debarquement Syndrome: A Case Report Highlighting the Difficulty in Diagnosis and Management.
MdDS is syndrome of oscillating vertigo following cessation of passive motion. The pathogenesis of this disorder is not well understood, but functional imaging studies suggest cortical connectivity dysfunction in feedback loops of the vestibulo-ocular system and visuo-spatial system. Patients go through multiple appointments and often specialist referrals before being diagnosed. ⋯ We present the case of a young, female active duty Air Force Captain who developed symptoms while deployed. She underwent multiple treatments with variable success. Her clinical course highlights the difficulties for patients and providers posed by suspected MdDS.